Challenge of politico-economic sanctions on pharmaceutical procurement in Iran: a qualitative study

Background: Politico-economic sanctions over the recent years have led to significant challenges in the pharmaceutical supply chain (PSC) in Iran. Given the importance of the chain's resilience for the health system and its impact on accessibility, equity, and public health, this study was conducted to determine the major challenges facing pharmaceutical procurement in Iran after the imposition of these sanctions. Methods: This study was a qualitative research with a content analysis approach conducted in 2019. Eighteen policymakers and administrative managers in food and drug administration of two Iranian Medical Universities and Iran's Ministry of Health were included in the present study via snowball sampling and semi-structured interview. The data were analyzed using the framework analysis of MAX QDA10. Results: Five main themes and 15 sub-themes were identified, which addressed pharmaceutical supply chain challenges under politico-economic sanctions. These included the challenges in financing, purchasing, importing, and manufacturing domestic products in addition to storing and distributing medicines, along with challenges facing the general public, particularly patients. Conclusion: The results revealed that pharmaceuticals are not immune to politico-economic sanctions, although they are not directly subjected to them. Sanctions, similar to any economic crisis, can affect public health and limit their access to healthcare. Identifying supply chain challenges and planning to address them could help policymakers find solutions to enhance PSC resilience in the future

A Survey on Prevalence of Ocular Complications and It’s Risk Factors in Diabetic Patients of Diabetic Center of Nader Kazemi Clinic Shiraz- Iran 1998-2010

Background & Objective: With respect to an increase in diabetes prevalence, and the likelihood of ocular complications among them, this study was conducted to investigate the prevalence and risk factors and incidence of the ocular complications in patients of Nader Kazemi, Shiraz Diabetic center from 1998 to 2010.Materials & Methods: In a cross sectional study , subjects were selected based on a systematic random sampling to investigate the incidence of the ocular complications and the influence of factors such as age, sex, types of diabetes, job, education, blood triglyceride (TG) and cholesterol level, Family history of diabetes, history of hypertension, history of participation in educational classes, methods of treatment, duration of diabetes and fasting blood sugar were considered on them.Results: Ocular complications were found among 229 diabetic patients (32.6%). patients having type II diabetic have more ocular complications comparing with patients with type I diabetes (P<0. 005). Factors such as job (P=0. 022), history of participation in educational classes (P<0. 001), education (P<0. 001), family history of diabetes (P<0. 001), blood triglyceride (TG) (P=0. 021), duration of diabetes(P<0. 001),age (P<0. 001), method of treatment(P<0. 001)and fasting blood sugar (P<0. 001) had a significant relationship with the occurrence of ocular complication. However, other risk factors such as hypertension,gender and cholesterol levels were not statistically significant relationship with the occurrence of ocular complication.Conclusion: Given the prevalence of ocular complications, educating diabetics’ patients can have a significant influence in reducing the occurrence of ocular complications